Abstract
BackgroundRecent studies suggest that routine postoperative laboratory tests are not necessary after primary elective total hip arthroplasty (THA). This study aims to evaluate the utility of routine postoperative laboratory tests in patients undergoing THA for hip fracture in a semi-urgent clinical setting.Materials and methodsThis retrospective study included 213 consecutive patients who underwent primary unilateral THA for hip fractures. Patient demographics, clinical information, and laboratory tests were obtained from the electronic medical record system. Multivariate logistic regression analysis was performed to identify risk factors associated with abnormal laboratory test-related interventions.ResultsA total of 207 patients (97.18%) had abnormal postoperative laboratory results, which were mainly due to anemia (190/213, 89.20%) and hypoalbuminemia (154/213, 72.30%). Overall, 54 patients (25.35%) underwent a clinical intervention, 18 patients received blood transfusion, and 42 patients received albumin supplementation. Factors associated with blood transfusion were long operative time and low preoperative hemoglobin levels. Factors associated with albumin supplementation were long operative time and low preoperative albumin levels. Of the 33 patients with abnormal postoperative creatinine levels, 7 patients underwent a clinical intervention. For electrolyte abnormalities, sodium supplementation was not given for hyponatremia, three patients received potassium supplementation, and one patient received calcium supplementation.ConclusionsThis study demonstrated a high incidence of abnormal postoperative laboratory tests and a significant clinical intervention rate in patients who underwent THA for hip fracture in a semi-urgent clinical setting, which indicates that routine laboratory tests after THA for hip fracture are still necessary for patients with certain risk factors.Level of EvidenceLevel III.Trial registration Clinical trial registry number ChiCTR1900020690.
Highlights
Along with the rapid aging of the global population, hip fractures continue to be a global concern
A total of 207 patients (97.18%) had abnormal postoperative laboratory results, which were mainly due to anemia (190/213, 89.20%) and hypoalbuminemia (154/213, 72.30%)
Factors associated with albumin supplementation were long operative time and low preoperative albumin levels
Summary
Along with the rapid aging of the global population, hip fractures continue to be a global concern. As a regional tertiary referral center, plenty of frail elderly patients with hip fracture and multiple comorbidities are transferred to our department. The majority of these patients are medically complex and surgery is usually postponed to allow for detailed medical evaluations to ensure that patients’ conditions are stable, and for preoperative correction (e.g., anemia, hypoalbuminemia) and medical optimization (e.g., pulmonary reserve, nutrition). This study aims to evaluate the utility of routine postoperative laboratory tests in patients undergoing THA for hip fracture in a semi-urgent clinical setting
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